Bedside Manners is a powerful patient safety and team building tool for healthcare professionals and patients alike. The play is designed to jump start or advance conversations about communication, patient safety, and teamwork within all areas of healthcare. Through interactive exercises it engages staff and patients into gripping teaching opportunities about the causes and consequences of ineffective communication between members of the healthcare team. It also helps builds a foundation of Team Intelligence that will lead to better practice and safer care.

Learning Objectives

At the end of this presentation participants will be able to:

Describe three examples of tensions that exist between physicians and nurses and other members of the healthcare team that may adversely affect their ability to work together

Describe how the tensions between doctors and nurses and other team members negatively impacts patient care

Describe a resolution of a conflict in a typical clinical scenario

Describe how another high reliability industry has dealt with teamwork problems and how it could apply to healthcare.

It is now established that patient safety and good working relationships depends on teamwork and communication. Teamwork does not, however, just happen. It cannot be built if people do not understand key teamwork concepts and develop key teamwork skills. This workshop will explore how those who provide health care as well as patients who receive health care services can develop team intelligence within their own profession and advocate for the promotion of team intelligence throughout healthcare. It will use interactive methods to help understand several key Team Intelligence concepts and develop several key Team Intelligence skills.

Learning Objectives

At the completion of this session the learner will be able to:

Explain team intelligence

Explore the need for using team intelligence concepts in interprofessional healthcare.

Describe the use of team intelligence in the aviation safety model (ASM) and how it relates to healthcare.

Collective Impact is the commitment of a group of actors from different sectors to a common agenda for solving a complex social problem. In order to create lasting solutions to social problems on a large scale, organizations – including government, civil society, and the business sector- need to coordinate their efforts and work together. No single organization can create large-scale, lasting changes alone. (FSG, Reimagining Social Change, 2015- www.fsg.org)

Panelists from New Brunswick and Nova Scotia will describe their collective impact models and priorities:

This session will introduce Collective Impact, a new way for people and organizations to mobilize their efforts for maximum effectiveness on complex or large scale problems; complex problems that we see played out in health care institutions every day but wonder how we as health care professionals can respond. Collective Impact is a concept that embraces a fundamentally different and more disciplined approach to achieving impact and we need to be involved. It is also supported within Horizon Health Network’s new Strategic Plan.

Living SJ is a leadership collective in Saint John that illustrates the five conditions that embody Collective Impact- shared vision of diverse partners driven by collectively agreed upon targets, coordinated and supported action plans, and continuous communication. The result is a five year social renewal strategy that will transform our Saint John neighbourhoods, close the education achievement gap, improve the health & well-being of our residents, and invest in our workforce. The speakers will focus on their experience using Collective Impact as the organizing framework for the Living SJ priorities of improving the health of residents through neighbourhood based centres and transforming low income neighbourhoods into vibrant mixed income communities

You Turns is a collective impact initiative, which at first glance, seems to address attendance issues but upon deeper reflection uncovers complex problems around Mental Fitness and Health. More profoundly it is about an urgent need for the entire adult community to reassess its approach so that we can impact positive change for our young people. So the first “You” in need of turning in You Turns is the adult community including Government, Non-Profits and Community. United Way plays a “backbone” role along with Anglophone East School District in supporting the shared work of stakeholders, including Public Health, Social development, Horizon NB – Addictions and Mental Health Services, NB Health Council, Codiac RCMP, Boys & Girls Club of Moncton, YWCA and other agencies with a direct stake in the common outcomes, and our early work has centered on the catchment area of two urban High Schools and their feeder schools.

Transitional care is defined as a set of actions designed to ensure the coordination and continuity of healthcare as patients transfer between different locations or different levels of care within the same location. Transitional care is based on a comprehensive plan of care and the availability of health practitioners who are well trained in chronic care and have current information about the patient’s goals, preferences and clinical status. Transitional care is essential for persons with complex care needs. (American Geriatrics Society, 2003)

Panelists from New Brunswick will describe their program or service and

1. The interprofessional and/or intersectoral team involved

2. How the service bridges the gap(s) between one healthcare provider/service team to another healthcare setting or other setting

3. How the service involve patients and families (as defined by the patient) in the care transition process.

4. What tools or processes are integrated into the service to support coordination of care with other sectors and agencies.

Chronic obstructive pulmonary disease (COPD) is currently the fourth leading cause of death in Canada and the most responsible cause of hospital admission in the country. INSPIRED (Implementing a Novel and Supportive Program of Individualized care for patients and families living with REspiratory Disease) was introduced in Halifax in 2010, recognizing that current models of care were largely reactive, under stress and failing, with significant costs to patients, families and the healthcare system. The model of care reduced patients’ use of acute care services by 70-80%, resulting in systems savings through reduced ER visits and “bed days” and patients reporting improved quality of life and a better ability to manage their illness.Based on these results, the program is now spreading across Canada. Josh Scoville will speak about the adaptation and implementation of the INSPIRED program in Saint John for patients and families living with moderate to severe COPD. He will highlight key program objectives and describe what the program entails, with an emphasis on the transition from hospital to home and patient and family-centred care. Once implemented in Saint John, the program will spread throughout Horizon Health Network.

The Patient Flow Project is an ongoing joint project of Extra-Mural Program and Hospital Services in Saint John and was initiated in late 2012. The purpose of the project is to plan, implement, and evaluate a new service delivery model for daily patient flow and discharge planning at the Saint John Regional Hospital. The issue of duplication of services, lack of seamless discharges or transitions in care has been a long-standing issue in the Saint John area.Colleen will describe the goals of the project, the tools used, efforts to create a culture of change on hospital units, team members’ role clarification, and indicators used to measure implementation. Tools include those to predict patients at greatest risk for prolonged hospital stay and complex discharge planning needs, to ensure patients and families are informed and engaged in the journey of care and to support staff in ensuring safe and effective transitions. Colleen will provide an overview of progress to date as well as lessons learned.

The Pediatric Patient Navigator service is available through Horizon Health Network and Vitalité Health Network from day one of the diagnosis. The Navigator is a nurse with education and expertise in children and adolescents’ cancer. The Navigator works closely with a child or teen’s health-care team in and outside of New Brunswick during cancer treatment to make the journey easier. The Navigator can help the patient and family understand the many challenges they may face and questions they may have about the child’s cancer. Every child or adolescent with cancer and their family have different needs, and will cope with having cancer in different ways. The Navigator can help the family access resources and supports for finances, travel, treatment and transition of care, according to the family’s needs. Access is by referral or families may self-refer at any point during the course of your child’s cancer care (diagnosis, treatment, follow up, or palliation etc.).

The Province of New Brunswick has adopted a child- and youth-centered Integrated Service Delivery (ISD) framework, intended to improve services and programs to children and youth deemed at-risk or having complex social, emotional, physical and/or mental-health needs. The development of this framework began with the acknowledgment of province-wide need to enhance services for youth with emotional/behavioural and mental-health concerns. The vision of ISD is to ensure the positive growth and development of at-risk children and youth as well as those with complex needs, through the collective impact of its partners working together in an integrated manner and with a child or youth-centered approach to develop and implement appropriate interventions based on the strengths, needs and risks of identified children and youth.

Collaborative inter-professional teams provide interventions and have a positive effect on service delivery processes and youth outcomes. Increasing collaboration among professions is intended to reduce duplication of effort, make more effective use of limited resources and more effectively meet the complex needs of children and youth. Services are designed to reach people in their own environments – at home, in schools, and in the community – and seek to strengthen the natural informal supports found within these settings.

Community-based rehabilitation services have been criticized for their singular focus on risk-need and the perpetuation of a deficit-based delivery framework. In contrast, the ISD framework places emphasis on elaboration of strength-based counselling or service modalities which underscore the importance of using the child or youths’ capacities, interests and preferences to realize and sustain positive changes. Strength-based methods affirm that children and youth and their respective contexts have a range of unique internal and external resources that should be used as part of the case planning process.

Today’s healthcare environment is increasingly complex. This requires an innovative and coordinated approach to deliver safe and quality patient care. It is widely acknowledged that the use of approaches that ensure coordinated and patient-centered care contribute to a sustainable and effective health care system. There is ample evidence to suggest that effective collaboration between health care professionals is a key factor to improving access, increasing organizational efficiency and delivering quality patient care. Interprofessional collaboration can contribute to improved team functioning and enhanced patient care.

New Brunswick home healthcare is holistic in nature and is delivered through the provision of coordinated services. In order to meet the identified needs of the client, service providers recognize the contribution of other providers, establish effective communications and work together in partnership. To further support this philosophy, the Extra-Mural Program is introducing “MY Health Plan”. MY Health Plan is a tool owned by the patient & family and is developed with the care team.

This session describes the tool and how the related elements around interdisciplinary teams, collaboration with formal and informal caregivers, action planning and goal setting work in conjunction with the existing system of home health care.